A memoir of love, hope, and empowerment by @MLWhitlock
A memoir of love, hope, and empowerment
At age twenty-six, author Michelle L. Whitlock thought she had it all: she was in the best physical shape of her life, she had a promising career, and she had a budding romance that looked like it could finally be the real thing. Then doctors informed her that she had HPV. Weeks later her worst nightmare became her reality: she was diagnosed with invasive cervical cancer. In this memoir, Michelle narrates the story of her ordeal. She tells how she took charge of her healthcare and pursued an experimental surgery that treated the cancer while preserving her fertility. The surgery was a success, but just years later-a week after the love of her life proposed-Michelle discovered her cancer was back.
How I Lost My Uterus and Found My Voice follows Michelle as she wonders if she will live or die, have children, or enjoy sex again. This is one woman’s story of falling in love, battling HPV and cervical cancer, facing sexual dysfunction, confronting her conflicting feelings about motherhood, and becoming her own best advocate. Inspirational and honest, this memoir tells the emotional story of love, loss, resilience, and survival.
Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis
A simple urine test which can detect the human papilloma virus (HPV) could offer women a much less invasive alternative to the cervical cancer screening or ‘smear’ test, experts have said.
New research published in The BMJ has revealed that the tests are accurate and efficient, and the doctors behind the study said that offering the test could help reverse a fall in the number of young women being screened for possible cancer.
To determine the accuracy of testing for human papillomavirus (HPV) DNA in urine in detecting cervical HPV in sexually active women.
Systematic review and meta-analysis.
Searches of electronic databases from inception until December 2013, checks of reference lists, manual searches of recent issues of relevant journals, and contact with experts.
Test accuracy studies in sexually active women that compared detection of urine HPV DNA with detection of cervical HPV DNA.
Data extraction and synthesis
Data relating to patient characteristics, study context, risk of bias, and test accuracy. 2×2 tables were constructed and synthesised by bivariate mixed effects meta-analysis.
16 articles reporting on 14 studies (1443 women) were eligible for meta-analysis. Most used commercial polymerase chain reaction methods on first void urine samples. Urine detection of any HPV had a pooled sensitivity of 87% (95% confidence interval 78% to 92%) and specificity of 94% (95% confidence interval 82% to 98%). Urine detection of high risk HPV had a pooled sensitivity of 77% (68% to 84%) and specificity of 88% (58% to 97%). Urine detection of HPV 16 and 18 had a pooled sensitivity of 73% (56% to 86%) and specificity of 98% (91% to 100%). Metaregression revealed an increase in sensitivity when urine samples were collected as first void compared with random or midstream (P=0.004).
The major limitations of this review are the lack of a strictly uniform method for the detection of HPV in urine and the variation in accuracy between individual studies.
Testing urine for HPV seems to have good accuracy for the detection of cervical HPV, and testing first void urine samples is more accurate than random or midstream sampling. When cervical HPV detection is considered difficult in particular subgroups, urine testing should be regarded as an acceptable alternative.
Sources and More Information:
Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis, BMJ 2014;349:g5264, 16 September 2014.
New urine test could replace invasive smear tests, TheIndependent Health News 9736609, 17 September 2014.
HPV urine test could screen for cervical cancer, NHS Choices, cancer, 17 September 2014.
It could be dangerous to use antiviral treatments or therapeutic vaccines with women whose lesions already show signs of HPV integration
A new understanding of the genetic process that can lead to cervical cancer may help improve diagnosis of potentially dangerous lesions for some women, and also raises a warning flag about the use of anti-viral therapies in certain cases – suggesting they could actually trigger the cancer they are trying to cure.